Join me as I half-ass my way through medical school, encountering all sorts of freaks (patients, classmates, myself, etc.) along the way

Monday, September 12, 2005

Not Quite That Stupid

It has become obvious to me over the past few weeks that you, the lay people, think doctors are complete idiots. That is the only explanation I have for some of lines I've been fed by various patients I have encountered over the last few weeks. Rather than fess up the actual reason(s) why they are in the hospital, many of these patients come up with extravagant lies that are so absurd, you'd have to be a complete and utter moron to believe them. What do I mean by all this? Let me submit these three case studies as examples, with dialogue as closely verbatim to what happened in real life as I can remember, and I’ll let you draw your own conclusions:

Patient: It’s the strangest thing. I just woke up one morning, and I had these two huge spider bites on my arms, one on my left and one on my right. They kept getting bigger and redder, and I guess they got infected, so now I’m here.

[A quick inspection of her arms reveals two quarter-sized lesions on opposite sides of her arm, mirror images of one-another]

Me: So you say you got these two spider bites in the exact same place on each arm at the exact same time?

[Patient begins scratching her neck]

Patient: Yep. Strangest thing, eh doc?

[Toxicology Screen: Positive for cocaine, heroin, etc.]

Me: Ya, I guess there’s some crazy spiders running around LA these days.

Case Study 2:[Patient in the ER, in an immense amount of pain]

Patient: I don’t know what happened. I was fine and all, and then suddenly I lost my strength and just fell down. I didn’t see it as I was falling, but I guess it was there the whole time. I fell right on it, and it went right through me. I am in a lot of pain, doc. It hurts so bad.

Trauma Team: OK, so we’re going to take a few X-ray’s and get to the bottom of this. Hopefully the pain medications will kick in soon.

[Trauma Team reviews the abdominal X-ray, which reveals an approximately 5-inch long metal object, clearly resembling a nail file, lodged partially in the sigmoid colon and rectum, and partially outside this space. It has perforated the colon.]

Team: Sir, it appears as if you have a nail file stuck in your anus and colon.

Patient [in feigned disbelief]: You mean to tell me I fell on a nail file? And it went through my butt into my colon?

Team: Umm…do you mean to tell us you fell on a nail file and it ended up in your colon?

Case Study 3:[Patient presents to ER, blunt head trauma, but still conscious, awake, alert, and oriented. A team of medical students is called to evaluate this patient. Time: Approximately 5 AM]

Team: Do you remember what happened?

Patient: Ya, so, I was just setting up a bed, putting the frame together, and something went wrong.

Team: What happened?

Patient: I don't remember how it happened, but the next thing I know, my head is being propelled right into the wall. My head went through the drywall, and it got stuck there. I was just trying to put the bed together for my friend, he just got a new mattress and everything. Oh, man, it hurts so bad.

Team: So let me get this straight: you were putting a bed together at 4 AM?

Patient: Umm…ya so-

[We receive a tap on the shoulder by an ER nurse, who shows us the patient’s original history he gave to the ER doctor, apparently after intensive interrogation:

“Patient was performing a sexual act with his partner involving repeated back flips. Patient did a back flip and accidentally propelled his head into the drywall.”

We leave the patient's bed.]

Right. So anyways, I just thought I’d share these brief tales as a cautionary piece of advice for any of you who might think you can get away with not telling us the real reason why you’re in the hospital. In general, it will be painfully obvious, and your lying to us will only make you look like a bigger idiot. And if you think the doctors don't sit around the doctor lounge telling everyone about the massive deuce you tried to feed them, then you've got another thing coming. And by "another thing" I mean a nail file right up your rectum.

As an aside, if anyone can explain to me how doing backflips while having sex enhances the sexual experience, I’d love to hear it. Then try it out, of course.

16 Comments:

What I personally get a kick out of is listening to the doctor try to maintain politeness while expressing doubts as to the veracity of the patient's story, because when they're dictating they apparently choose not to just say "The patient is a lying cretin." So I get things like (ooh, let's use your nail file example):

I am unclear as to the exact mechanism of injury, given that the patient's history is somewhat incongruent with radiographic findings.

And so on.

So start practicing your polite ways to say "This patient is completely full of it." Or (better yet) don't! It would be way more entertaining for the transcriptionist if you didn't.

The question about how backflips improve sex probably is one for Dan Savage. Incidentally, he has a similar problem in his profession as sex advice columnist: the "How'd That Happen?!" letter, in which the writer wants advice on some peculiar thing she's done but claims that she did it purely by accident.

they DO think we are idiots...honestly, how many times can you "accidently" flush your vicodin down the toilet at 4:59 pm on a saturday afternoon, when the pharmacy closes at 5 and your doctor just went to subsaharan africa!

Hah.. as a fellow student, can’t say I have experienced stories QUITE like that–except in the psych wards of course. Though I have to say one of the strangest incidences I experienced was on call in the peds ER one night. This kid comes in with the chief complaint of “A catfish attacked me.” He had apparently been gouged by a catfish whisker during a fishing trip by a catfish that was still struggling after capture. To his credit, it was a nasty looking sting. Half an hour later after he was discharged a little girl comes in with a fishhook through her finger. A few minutes into her history I discover that she’s the cousin of the first kid. The poor kid hadn’t even gone fishing! When the crew returned she tried to grab some items off a bicycle and ended up grabbing a sharp fishhook.

Halucinations could definitely be the answer . . . I've been thinking about the kind of sexual acts a person can perform while doing backflips, and assuming its a 2 or more person act and standard gravity applies . . . halucinations sound more viable. Or has my imagination failed me?

I wonder idly if Anonymous also had halucinations about sexual acts involving multiple backflips? The "It happened to me" ending sounds promising. My experience with head trauma was disappointingly banal.